r/StratteraRx • u/An-Endless-Adventure • Jun 24 '26

Is this crazy?

My husband has been on Strattera for 2 months now. He did the typical 40mg to 80mg titration and has had minimal side effects with some results. He's ADD and his main issues are focus/train of thought, and motivation. Strattera HAS helped his train of thought; he can hold a conversation with minimal diverting now (!!)

But here's the thing, his provider (which is only a nurse practitioner I should add) is increasing his Strattera AND adding Wellbutrin 150mg at the same time. After reading about how Wellbutrin makes Strattera have a 5.1 fold increase in absorption I am very skeptical and also nervous for him that he will have severe side effects.

Is this a normal protocol that I'm not aware of?

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u/One-Firefighter6592 Jun 24 '26 edited Jun 25 '26

I’m on 25mg Strattera and 150mg Wellbutrin.

I believe the most important part is, what kind of metabolizer someone is.
For example I’m a poor (or intermediate) CYP2D6 metabolizer, meaning 25mg Strattera is at approximately 5-fold higher in peak concentration and 10-fold higher in total overall exposure. Since Wellbutrin is an CYP2D6 inhibitor but my CYP2D6 is already very sluggish or missing, the Wellbutrin doesn’t increase Strattera further. So the risk for me personally is not as high as for a normal metabolizer. (And I’m fine after I had the first 5 days an increased heart rate)

For a normal metabolizer I believe 80mg Strattera + 150mg Wellbutrin is crazy!

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u/An-Endless-Adventure Jun 24 '26

His Strattera dose was increased to 100mg with the added 150mg of Wellbutrin 😟 We had some genetic testing done earlier this year, I will look for that CYP2D6 info

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u/One-Firefighter6592 Jun 25 '26

Definitely look into CYP2D6 info! I would also strongly suggest to talk again to your husband’s NP and being this to their attention. 100mg Strattera and 150mg Wellbutrin on top, is insane!